Questions for Men About Prostate Cancer

Q. What is prostate cancer?

A. Prostate cancer is a malignancy that develops from cells of the prostate gland that may eventually spread outside the gland to other parts of the body. It is one of the most common types of cancer among American men. It is usually found in men older than 65. The prostate gland is about the size of a walnut and is behind the base of the penis and under the bladder. The main function of the prostate is to make fluid that carries sperm. Most prostate cancers grow very slowly; some, however, spread quickly to other areas.

Q. What causes prostate cancer?

A. It is not known exactly what causes prostate cancer, though researchers have identified some risk factors. A risk factor is anything that increases your chances of getting a disease. Researchers are making progress toward understanding how these factors cause cells in the prostate gland to become cancerous.

Age is the most important risk factor. It is rare in men younger than 40, and about two out of three cases are found in men older than 65. Prostate cancer is more common in African American men. Having a father or brother who has had the disease increases your risk.

Evidence exists that development of prostate cancer is linked to increased levels of androgenic hormones in some men. It is thought that high levels of androgens (male hormones) may contribute to prostrate cancer risk in some men. Additional research is needed to evaluate the practical value of these observations.

Q. Can prostate cancer be prevented?

A. Because the exact cause of prostate cancer is not known, doctors aren't certain how to prevent most cases of the disease. Risk factors such as age, race, and family history are beyond a man's control. One possible risk factor that can be changed is diet. A diet high in animal fat--dairy and meat--seems to increase the risk for prostate cancer. The American Cancer Society (ACS) recommends a diet low in fat and consisting of mostly vegetables, fruits, and grains.

Q. Is early detection of prostate cancer possible?

A. Yes. Through yearly blood tests for a substance called prostate-specific antigen (PSA) and digital rectal exams (DRE), most cancers are detected before symptoms appear. Because the prostate lies in front of the rectum, it can be examined by a DRE. If either the PSA or DRE are abnormal, then further testing should be done. Some prostate cancers may be found because of symptoms, such as a slowing, weakening, or interruption of the urinary stream or the need to urinate more often, especially at night. Symptoms of advanced prostate cancer include blood in the urine, swollen lymph nodes in the groin area, impotence (difficulty having an erection), and pain in the pelvis, spine, hips, or ribs.

Early detection may prove beneficial for some men. The ACS recommends that men 50 and older discuss the risks and benefits of screening with their doctor. This discussion should start at age 45 if you are African American or you have a strong family history of prostate cancer.

About 80 percent of all prostate cancers are found when the cancer is confined to the prostate. The five-year survival rate for cancer found there is nearly 100 percent. For cancer than has spread from the prostate to nearby areas but not to other organs, the survival rate is also nearly 100 percent at five years. Over the last 30 years, the five-year survival rates for all stages combined have increased dramatically.

Q. Am I at risk for prostate cancer?

A. Several factors, such as age, race, nationality, diet, physical activity, and family history, are consistently associated with an increased risk of developing prostate cancer. African American men and men who have a family history of prostate cancer in a father or brother are at higher risk.

Q. Should I be tested for prostate cancer?

A. The ACS recommends that most men older than 50 find out if prostate cancer screening is right for them. Because African American men and men with a father or brother with prostate cancer are at a higher risk than other men, the ACS recommends that these men talk with their health care provider about screening by age 45. The ACS encourages men to learn about this disease and talk with their doctors about whether prostate cancer testing is right for them.

Q. What are the different ways to treat prostate cancer?

A. Many different ways exist to treat prostate cancer, including surgery, radiation therapy, hormone therapy, chemotherapy, expectant therapy (watching-and-waiting or deferred therapy), and experimental/clinical trials. Men need to discuss the most appropriate course of action with their doctor.

Q. Can prostate cancer be cured?

A. Prostate cancer can be cured in many cases if diagnosed early enough. Nearly 100 percent of those with the disease confined to the prostate gland will survive at least five years. For those with cancer than has spread outside the prostate but not to other organs, the five-year survival rate is also near 100 percent. For cancer than has spread to other organs, the prognosis will depend on response to hormonal therapy, chemotherapy, and/or radiation therapy, as well as the man's overall health.

Q. How many new cases of prostate cancer are diagnosed each year?

A. The ACS estimates that annually about 218,000 new cases of prostate cancer are diagnosed in the United States. For as yet unknown reasons, African American men are more likely to have prostate cancer and to die from it than are white or Asian men.